Much has been written recently about President-Elect Trump’s nominee for Secretary of Health & Human Services, Rep. Tom Price (R-GA). A former orthopedic surgeon from suburban Atlanta, Price has served six terms in the House and is currently Chairman of the House Budget Committee. A recent article in The Washington Post reports Congressman Price "got into government to get government off his back."
He has been one of the strongest critics of the ACA and campaigned with Trump early on because Trump said he would repeal Obamacare. Price’s vision for health reform is laid out in legislation he introduced in 2015, the “Empowering Patients First Act.” Many of his proposals are similar to those outlined in House Republican leaders’ “Better Way” reform proposal.
Price would like to scale back much of the federal government's role in health care in favor of a free-market framework built on privatization, more flexibility for states, and tax code changes including a cap on the employee tax exclusion for employer-provided coverage. His vision includes repealing the ACA and reducing Medicare and Medicaid spending. These health entitlement cutbacks could have significant consequences for employers and corporate America by ultimately leading providers to shift more cost to private payers -- largely employer health plan sponsors.
As the Republican Congress moves to repeal and replace the ACA, Price will be a key player in negotiations with lawmakers, and the Center for Medicare & Medicaid Services (CMS) within HHS would actually set up and administer a replacement plan. In the meantime, there are some regulatory steps that HHS and other agencies could take to undermine the law, such as modifying or revoking final rules through the notice-and-comment rulemaking process. Agencies can also simply decline to enforce rules for a time.
Of particular interest to employers should be Price’s oversight of CMS’s Center of Medicare and Medicaid Innovation, which has supported experiments in health care payment reform such as encouraging a shift from fee-for-service to value-based models. Price in general does not support limiting physician discretion, which may put the fate of these programs in question.
Price’s nomination signals that big health policy changes are coming, though details and timing are in flux. We are closely monitoring developments with an eye to the impact on employers. Our intention is to help serve as a voice and advocate for the employer-sponsored health benefits system that provides coverage to 170 million American workers, retirees, and their families. As we formulate policy positions in support of that system, we will share them with the employer community and look forward to working together to meet the challenges and opportunities ahead.